EMHS Tobacco Brief Intervention ABCD Pilot Project Armadale Hospital. Assunta Di Francesco Senior Health Promotion Officer
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1 EMHS Tobacco Brief Intervention ABCD Pilot Project Armadale Hospital Assunta Di Francesco Senior Health Promotion Officer
2 East Metropolitan Health Service City of Armadale City of Bayswater City of Belmont City of Canning City of Gosnells City of Kalamunda City of Perth City of South Perth City of Swan Shire of Mundaring Shire of Serpentine Jarrahdale Town of Bassendean Town of Victoria Park
3 ABCD aim To increase the number of people who accessed Armadale Hospital s Canning Ward to be smoke free during their hospital stay.
4 Rationale Pharmacological treatment can improve patient comfort and compliance with hospital smoke free policies (Department of Health, 2009). BI delivered by a health professional can double the rate of quitting (Stead, Bergson and Lancaster, 2008). Documenting smoking status, providing brief counselling and pharmacotherapy to smokers and offering post hospital discharge support can improve long term smoking cessation among hospital patients (Mullen et al 2016).
5 ABCD A Ask B Brief Intervention CD Communication at Discharge Ask all inpatients about smoking. Every inpatient who smokes should be offered brief intervention support to quit. Communicate smoking status and action taken in discharge documentation. Determine nicotine dependence Offer NRT Offer referral to relevant supports
6 A capacity building approach Leadership Management support Policy to influence change Learning from Alfred Health s experience Resource allocation Quit packs Flow charts Nicotine test for dependence lanyards Partnership Armadale Hospital Cancer Council WA Workforce development Information sessions with physicians and nurses Organisational development Identifying pilot ward Use available best practice tools Fagerström Test for Nicotine Dependence Audit processes
7 What we did Physician information session (1) 20 participated Nursing information sessions (6) 56 participated Quit packs 253 distributed Fagerström Test for Nicotine Dependence cards - lanyards 50 distributed
8 Evaluation Patient file audit Information session surveys Observational audit
9 Patient file audit Four patient file audits two month interval Internal processes (e.g. GEKO form, Business Intelligence Unit) ABCD Audit Data Sheet (excel)
10 Sample size Measure Audit 1 Audit 2 Audit 3 Audit 4 Total Month June 2017 August 2017 October 2017 December 2017 No. of records identified to audit Actual no. of records audited out of total number (Sample size) 16 (36 per cent) 13 (56 per cent) 31 (94 per cent) 14 (73 per cent) 74 (62 per cent)
11 Summary of results
12 Limitations Small sample size Limited resources and capacity Limitations of auditing recording process
13 Recommendations Continue project for another 12 months. Include information on NRT and CD component during interns (junior physicians) orientations. Continue to deliver sessions to nurses. Survey nurses to identify support needs. Expand project to other departments and general practice surgeries.
14 References Department of Health Clinical guidelines and procedures for the management of nicotine dependent in-patients. Accessed April 2017, cco/pdf/clinical_guidelines.pdf Mullen KA., Manuel GD., Hawken SJ., Pipe AL., Coyle D., Hobler LA., Younger J., Wells GA and Reid RD Effectiveness of a hospital-initiated smoking cessation programme: 2 year health and health care outcomes. Accessed April 2017, pdf Stead L., Bergson G., Lancaster T. Physician advice for smoking cessation. Cochrane Database Systematic Review 2008: (2) CD
15 Acknowledgements Alfred Health Emma Dean Kirsten Corben Kia Noble Armadale Health Service Dr Rasiah Sureshkumar Michelle McGowan Lynda Sutton Edwina Lee Evonne Fong My Linh Nguyen Jill Claybrook Cancer Council WA Doris Neuwerth Kelly Kennington East Metropolitan Community and Population Health Services Megan Milligan Polash Mondal Holly Scott Claire Hyland Wendy Kippin Tobacco Control Network Sarah Bright
16 Thank you Contact details: Assunta Di Francesco Senior Health Promotion Officer-South East East Metropolitan Health Service Tel:
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